潍坊市2005-2015年HIV/AIDS病例晚发现情况分析

Analysis on the late diagnosed HIV/AIDS cases reported during 2005-2015 in Weifang city

目的分析2005-2015年潍坊市新发现艾滋病病毒(HIV)感染者/艾滋病(AIDS)病例(简称HIV/AIDS病例)的晚发现情况。方法从中国艾滋病综合防治信息系统中,选择2005-2015年新发现的、现住地为潍坊市的HIV/AIDS病例,按照目前中国使用的晚发现定义标准,分析不同情况下的晚发现比例。结果潍坊市2005-2015年658例HIV/AIDS病例中,晚发现病例182例,占27.66%。从多年的晚发现率分析,晚发现率总体呈下降趋势(χ~2趋势=5.725,P<0.001)。HIV/AIDS病例中,女性、50~59岁年龄段、小学及以下文化、农民、输血/血制品传播、样本来源于临床检测的晚发现率,分别高达43.61%、48.48%、43.07%、42.62%、88.24%、47.93%。单因素和多因素Logistics分析结果显示,性别、年龄、文化程度、职业、传播途径和样本来源是HIV/AIDS病例晚发现的独立影响因素(P<0.05);多因素Logistics回归分析显示,晚发现风险女性病例是男性的1.71倍,40~49岁、50~59岁年龄段分别是20~29岁年龄段的1.72和1.69倍,小学及以下文化是大专及以上的1.61倍,农民是其他的2.43倍,输血/血制品传播是同性性传播的2.35倍,样本来源于临床检测者是无偿献血者的5.90倍。结论潍坊市样本来源于临床检测病例的晚发现较为严重,应进一步加强对女性、高年龄段、文化程度偏低、职业为农民等重点人群的艾滋病扩大检测力度。

Objective To analyze the late diagnosed HIV/AIDS cases reported during 2005-2015 in Weifang city.Methods All the HIV/AIDS cases were collected from the national comprehensive information system of HIV/AIDS control and prevention.Rates of the late diagnosed cases were stratified according to the demographic indicators.Results The rate of late diagnosed HIV/AIDS cases was declining during 2005-2015（χ~2=5.725,P0.001）,with the high rate of 43.61% among females,48.48% between 50 to 59 years old,43.07% of primary school education and illiteracy,42.62% peasants,88.24% infected with HIV via blood transfusion or blood products,and 47.93% detected from clinical HIV testing.Gender,age,educational levels,occupations,transmission routes and sample sources were independent factors of late diagnosis（P0.05）.Females had higher risks of late diagnosis（OR=1.71,P=0.019）.Compared with the cases20 years old,those between 40 to 49,and 50 to 59 years old had higher risks of late diagnosis（OR=1.72 and 1.69）.Those of primary school education and illiteracy had higher risk of late diagnosis（OR=1.61,P=0.013）.The HIV/AIDS cases of peasants had higher risks of late diagnosis（OR=2.43,P=0.001）.The cases infected with blood transfusion and blood products had higher risks of late diagnosis than those with homosexual behaviors（OR=2.35,P=0.002）.The samples from medical institutions had higher risks of late diagnosis than those from voluntary blood donation（OR= 5.90,P=0.001）.Conclusion Among the reported HIV/AIDS cases during 2005-2015,the late diagnosis from clinical HIV testing was high.We should expand the coverage of HIV detection and pay more attention to the people,especially females,the groups with high age and low education levels,and peasants.